手术治疗盆底功能障碍性疾病70例分析

    Surgical therapies for pelvic flour dysfunction: Report of 70 cases

    • 摘要: 目的:评价盆底功能障碍性疾病(pelvic floor dysfunction,PFD)两种手术方法治疗效果。方法:PFD 70例,25例行阴式子宫切除及阴道前后壁修补术(传统组),45例行保留子宫的盆底重建及经闭孔尿道中段无张力悬吊术(重建组),比较两组手术时间、术中出血、排气时间、保留尿管时间、术后病率及疗效等情况。结果:重建组手术时间、术中出血、排气时间、保留尿管时间、术后病率分别是(95.4±20.5)min、(133.2±17.7)ml、(24.5±6.5)min、(34.6±9.4)min及2.22%;传统组分别为(155.7±18.6)min、(305.2±44.7)ml、(46.6±5.8)min、(118.9±8.5)min及12.00%,两组差异均有统计学意义(P<0.01)。重建组及传统组总有效率分别为97.78%和76.00%,重建组明显优于传统组(P<0.01)。结论:保留子宫的盆底重建及经闭孔尿道中段无张力悬吊术治疗PFD手术时间短,出血少,疗效好,复发率低,技术易掌握,值得推广。

       

      Abstract: Objective: To evaluate the efficacy of two procedures for management of pelvic flour dysfunction(PFD).Methods: Of the 70 cases of PFD,25 were performed vaginal hysterectomy plus colporrhaphia anterior-posterior(tradition group) and 45 pelvic flour reconstruction surgery plus transobturator suburethral tape ventrofixation(reconstruction group).The clinical parameters were observed and analyzed.Results: The operation time,blood loss,recovery time of postoperative gastrointestinal function,recovery time of urination and the rate of postoperative diseases were(95.4±20.5) min,(133.2±17.7) ml,(24.5±6.5) min,(34.6±9.4) min,2.22% in the reconstruction group,and(155.7±18.6) min,(305.2±44.7) ml,(46.6±5.8) min,(118.9±8.5) min,12.00% in the tradition group,respectively.There was a significant difference between the two groups(P<0.01).The total effective rates in the reconstruction group and tradition group were 97.78% and 76.00%,respectively.The difference was significant between the two groups(P<0.01).Conclusions: Pelvic flour reconstruction surgery plus transobturator suburethral tape ventrofixation is effective for treatment of PFD,with the advantages of shorter operation time,lower volume of blood loss and less recurrence rate.The technique is easy to master and worth popularizing.

       

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